Challenging Dogma - Fall 2007

...Using the social and behavioral sciences to improve the practice of public health.

Wednesday, December 12, 2007

Promoting Abstinence—Unsuccessful among Teenagers and Government’s Public Health Failure to Educate – Crystal Warren

One of the biggest problems and fears American society faces today is sexual activity among the adolescents because of the behavior’s risky nature and the possible consequences like pregnancy and sexually transmitted infections (STIs). Even though rates of teenage pregnancy and birth have declined in the United States (US) since the 1990s, American teenagers still have the highest birth rate and one of the highest rates of STIs compared to their peers in the industrialized world (1). Experts in the public health community believe these statistics relate to the quality of sex education the youth receive today. One form of sex education teaches abstinence and contains additional information on safe sex practices by, for example, providing condoms and explaining its proper uses. On the other hand, there are also education programs that are strictly about abstinence-only-until-marriage. In 2002, both federal and state governments spent about $1.5 billion on a wide variety of contraception promotion and pregnancy prevention programs for teens and more than one-third of that spending went specifically towards funding contraceptive programs for the same age group. However, abstinence programs received only $144 million that year; so for every dollar spent on encouraging abstinence, the government spent $12 to promote contraception (2). Thus, lack of a sufficient investment into abstinence-only education programs has contributed to their failure in reducing STI and pregnancy rates among teenagers in the US. Abstinence-only has been a failure because of the improper framing of the issue (Framing Theory) in addition to flaws in its marketing tactics to teenage targets (Marketing Theory) and over reliance on social networks to change behavior (Social Network Theory).

Sexual activity connotes risky behavior, and the adolescence, constituting pre-teenagers and teenagers (ages 10-19), often model behaviors of risk-taking. Clinical psychiatrist, Lynn Ponton states that all teenagers take some risk as a normal part of growing up. Risk-taking is the tool an adolescent uses to define and develop his or her own identity (3). They like to experiment, try new things, satisfy their curiosity, and above all, rebel; it is all a part of their nature and growth. However, the decision to engage in sexual activities is a choice that teenagers can make. Even though, in the end, they are responsible for their own actions, parents and the government still feel obligated to protect their children.

According to the online campaign 4Parents.gov, a government-affiliated promoter of abstinence, telling the youth to wait until after marriage is the best answer to dealing with the problem with teenagers and sex. Delaying sexual activity is what will protect them and reduce putting their health at risk. As a national public education campaign, 4Parents.gov serves as an information guide for parents to attain the necessary skills and facts to help their children make healthy choices and steer away from risky ones. It encourages every parent to talk to the adolescents who are most prone to participating in sexual activities (4). To facilitate these discussions, the website provides three categories of information for parents: talking about waiting, youth behaviors, and sexual development and reproduction. The website also presents a national media campaign video, which emphasizes the importance of parents talking to their children about sex. Although all of these features of the 4Parents.gov campaign appear to be a productive government strategy to address the nation’s problem with teenagers having sex and pregnancy, it has largely been a failure. The campaign’s attempts to indirectly influence adolescent sexual behaviors and decisions through parents are largely ineffective because information on it may apply to some people and not to others. In addition, 4Parents.gov makes assumptions and misconceptions, based on social and behavioral science principles, about parents’ perceptions and beliefs about sex and their teenage children.

Framing a guide that only some, not all, can use
The 4Parents.gov is a failed campaign because of how the government frames the issue for the public. In this way, there is selectivity for who can use the guide and apply it to parents’ personal lives when talking to their teens. Without properly framing the problems in sexual activity among the adolescents, there is minimal chance for a change in behavior at the social level, especially when the website is addressing parents for behavior change among their children. Sex and abstinence is an issue about teenagers that pertains to all parents because at some point, every child will reach puberty. According to the Framing Theory, how one frames an issue influences behavior because it affects how people respond to it. Effort is devoted towards shaping the public’s views on health issues and the power of these campaigns is revealed in often contentious battles over what information should be presented (5). In 4Parents.gov, the government structures its arguments around its own values regarding sex and abstinence rather than helping parents incorporate their own values. For example, for parents who have a child that is sexually active, they are told how to convince their teens to stop having sex by telling their children that they are “worth it” (4). But, there are no further suggestions for parents who do not convince their teen to stop being sexually active implying that these youth are not “worth it.” Instead of a parenting guide to promote abstinence, 4Parents.gov’s so-called advice for communication between a child and parent is merely a framework of parenting rights and wrongs in beliefs systems. Thus, the focus of the issue with teens and sex appears to shift into more of a parent concern at the individual level from what was thought to be a problem for teenagers at the group level.

The government shapes teenagers and sex as a problem for parents by emphasizing how parents are responsible for their children and the importance of voicing their expectations and values to them. Therefore, parenting the right information about abstinence is important. The Framing Theory shows how a group is different than a collection of individuals because a group can be affected at the same time in behavior. Even though 4Parents.gov claims to be a guide intended for all parents, it only addresses a select few because it has pro-life and anti-gay framing implications. The website suggests that for pregnant teenagers, adoption may be the best choice for the baby and the teen parents. It also states that abortions results in women saying that they feel sad and there are some who use more alcohol or drugs than before (4). Not only do these statements apply to some and not all females who receive abortions, but they leave no parental advice for people who are pro-choice. By advising adoption, there is no effect or any connection to supporting abstinence but merely political support for life. By not reaching out to the population of already pregnant female teens, they do not know the needed details to making healthy choices thereafter, another promise of the website.

The government labels teenagers, who are lesbian, gay, bisexual, and transgender, as an “alternative lifestyle” and proposes to parents the possible need of special counseling, like therapy. To Frank Floyd and Terry Stein, sexual orientation is not a matter of lifestyle but an aspect of gender identity (6). The 4Parents.gov fails to meet the unique needs of these parents and in effect, cannot offer a way for them to encourage abstinence among their children. Nevertheless, along with excluding parents of sexually active teens, the campaign leaves parents of already pregnant girls out as well as parents with children who are lesbian, gay, bisexual, transgender, and experimenting in sexual orientations. In this way, 4Parents.gov appears to be specifically for the select few who are parents of the nonsexual and heterogeneous youth, based on its framework. Thus, it gives no results in telling parents that teenagers should not be having sex. Giving advice always has its drawbacks; not everyone can apply it to their lives. Under the circumstances of unfit framing implications that only present parenting information for exclusive individuals instead of parents as a group, 4Parents.gov fails to provide a guide for all to use.

Unsuccessful marketing
The Bush Administration advertises the 4Parents.gov campaign in the media, but it still falls short in sending out its message of abstinence by misusing the Marketing Theory. Not only is it unclear who the target audience is in the commercial but it also contains confusing information which, in effect, could keep the campaign even further away from its intended goal. First, the commercial features a group of pre-teenagers and teenagers asking their parents to talk to them about sex and how if they do not talk to them, there are other ways to be informed (i.e. the internet and friends). As a result, the ideal choice is to talk with them personally on living healthy. Nevertheless, the use of the youth’s innocent voices and how it may touch a parent catches the audience however, as the commercial concludes, the narrator abruptly enters telling parents to talk to their children about not having sex until after marriage. This completely negates the original message in that it now misleads parents into thinking the whole purpose of this “talk” with their teenagers is to discourage them from having sex entirely instead of what they thought to be a promotion of healthier lifestyles, especially if their child engages in sexual activities. Also, parents initially may not know this is a message for them with all the youth talking; they may think it is a commercial for kids prompting them to change channels before it is over. The narrator encourages parents to go on its website for information but material on it may be more suitable for the adolescents making it unclear who the true intended target is in the campaign. For example, definitions of penis and vagina are rather elementary for an adult crowd possibly making the site look more appealing and interesting to the youth. Because the government is using parents to communicate with teenagers, its tactics give divergent results.

Marketing to parents, but presenting messages that educate teenagers does not work because there is no definitive target audience. According to the Marketing Theory, messages in advertisements should reflect what the public wants. Waiting until marriage to have sex is not necessarily a public consensus nor is it realistic because in truth, almost all Americans have premarital sex and take such behavior as the norm. By age 20, about 75% of people have had premarital sex (7). A statistic like this definitely questions the effectiveness of the campaign and brings doubt that promoting abstinence is even proper education. Therefore, a commercial with the core message like waiting until marriage is not the best advertising tool for promoting abstinence among the youth, especially when the statistical figure does not reflect it. The message also leaves adolescents, the biggest group among rebels, with nothing but even greater curiosity and more interest in sex. It does not help parents in communicating with their children either.

The Marketing Theory says that a campaign should find out what the public wants and mold its messages to fit the demand; similarly to social marketing, the promotion goal is voluntary but has to be presented as attractive in the sense of its costs and benefits (8). In this particular commercial, 4Parents.gov presents the goal of abstinence with “rewards” such as potential awkwardness between parent and child and confusion. Without personal incentives, not all adolescents want to talk to their parents about sex, a topic that can make them uncomfortable and embarrassed. Nonetheless, despite its efforts to market to either parents or the youth over the years, 4Parents.gov is still unsuccessful. As of 2005, nearly half (47%) of high school students had ever had sexual intercourse. Of approximately 19 million new STIs, almost half were among the age group 15-24. Lastly, for all pregnancies in 2000, 13% of them occurred among adolescents (9). With these astounding numbers, this proves the government’s needed improvement in its campaigning for abstinence, even if it is via a universal marketing tool like television.

Adolescents act on their own behalf
Promoting abstinence by way of the 4Parents.gov website does not work because it appears to rely and incorporate principles of the Social Network Theory. This theory assumes behavior changes on the social level, that is, depending on the people around and associated with the individual. The key to a social network, though, is the relationship between and among individuals and how the nature of those relationships influences beliefs and behaviors (8). Adolescents mostly belong to social networks including their family and friends because these networks play important roles in whether these individuals act in ways that are either risky or good for their health. Social networks determine whether someone adopts a certain behavior or not. In this case, the networks teenagers are associated with definitely affect how they act, but not necessarily in a positive way.

Besides their parents, teenagers’ greatest source of communication and a social life is with their friends and peers. At the most prominent age of “rebellion,” young adults are not expected to listen to their parents. Instead, they follow whatever is “in” and most popular among their own social networks of friends; the goal is to expand their circle of friends (10). Even if teenage friends influence each other, it is not necessarily the intentions of 4Parents.gov and that is to promote abstinence. The campaign should not rely on parents to influence their children’s behaviors because as a part of their nature, they will not listen. Also, not only do the youth feel embarrassed about talking about sex with their parents; they fear their parents are not open either and will constantly badger them. To avoid awkwardness and confrontation with parents, there is always education from entertainment, including music, television, magazines, and the Internet (11). However, the greatest source is their own friends because they know that their own peers are going through the same experiences. Adolescents are inclined to emulate their peers because it is how they gain desired feelings at their age, like intimacy, social status, and even sexual pleasure (12). Also, they hear typical reasons to do something, like “everyone is doing it.” Pressure to feel accepted and liked often leads teenagers to make risky choices and partake in dangerous activities, including having sex, only to prove themselves in society among others in their social networks. For the government to put responsibility and assume parents can single-handedly change teenage behavior—by simply telling them to wait until marriage—is thoughtless and shows weaknesses in its campaign. Using parents to manipulate their children is a bad idea because in the end, teenagers act on their own behalf, and not through others, especially their parents. After all, they are more inclined to be influenced by their social network of peers.

Conclusion
Campaigns that affect and address everyone’s sexual health have great potential to help people, especially the most vulnerable and innocent group like the adolescents, in adopting healthy behaviors. Successful abstinence-only programs are ones that can educate and help people make use of in hopes of changing the “teen sex epidemic.” However, with no declining numbers in teenage pregnancies, sexually transmitted infections, and simply the number of sexually active teenagers, a campaign like 4Parents.gov proves that perhaps influential abstinence-only programs do not exist. To promote a universal topic like abstinence is difficult and must be handled carefully because it relates to everyone and it starts at youth. This government-run guide for parents is ineffective and fails at improving the well-being of teenagers because it is not a tool for everyone and it makes an indirect attempt at addressing the true target: adolescents. Framing tactics, the media, and social networks all affect people; the way the Bush Administration used the three in their campaign sure was not to their advantage in behavior change. In this way, the site comes off to be rather insensitive and confusing. To make a change among the youth, there must be better ways to communicate and voice the ideal behaviors that not only improve their health but those in the future as well.

References
1. Advocates for Youth. Five Years of Abstinence-Only-Until-Marriage Education: Assessing the Impact. Washington, DC: Advocates for Youth, 2004.
2. Pardue M.G. Government Spends $12 on Safe Sex and Contraceptives for Every $1 Spent on Abstinence. Backgrounder of The Heritage Foundation 2004; 1718: 1-23.
3. Ponton L. The Romance of Risk. Mothering Magazine 1998.
4. United States Depart of Health & Human Services. 4Parents.gov. Washington, DC: HHS. http://www.4Parents.gov.
5. Rothman A.J. and Salovey P. Shaping Perceptions to Motivate Healthy Behavior: The Role of Message Framing. American Psychological Association 1997; 121:1, 3-19.
6. Floyd F.J. and Stein T.S. Sexual Orientation Identity Formation among Gay, Lesbian, and Bisexual Youths: Multiple Patterns of Milestone Experiences. Journal of Research on Adolescence. 2002; 12:2.
7. Warner J. Premarital Sex the Norm in America. WebMD Medical News. 2006. http://www.webmd.com/sex-relationships/news/20061220/premarital-sex-the-norm-in-america.
8. Edberg M. Essentials of Health Behavior: Social and Behavioral Theory in Public Health. Sudbury, MA: Jones and Bartlett, 2007.
9. National Center for Chronic Disease Prevention and Health Promotion, Division of Adolescent and School Health. Sexual Risk Behaviors. Atlanta, GA: Center for Chronic Disease Prevention and Health Promotion, 2007.
10. Irvine M. Survey illuminates teen social networks. USA Today. 2007.
11. MacNeil J. Parents and Teens Find it Hard to Talk about Sex. Village Life News. 1996.
12. Habib L. Why Do Young Teens Have Sex? WebMD Medical News. 2006. http://www.webmd.com/news/20060614/why-do-young-teens-have-sex.

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2 Comments:

  • At December 13, 2007 at 6:27 AM , Anonymous Meg Gavaghan said...

    Hi Crystal! I think your argument regarding the Social Network Theory is really interesting. With teens being rebellious as it is, you're right in arguing that parents' influence may not be as great as their peers. Nice job!

     
  • At January 19, 2009 at 1:50 PM , Blogger The Scott said...

    It's one thing for parents to encourage youth to wait until they are an adult for sex. But scaring the hell out of the kids about it and telling them a condom is a provision for sin is a public health nightmare. Get the facts about premarital sex in the Bible that your church won't tell you about.

    http://www.NotAnotherGeneration.com

     

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